April 4, 2024 — A new study finds that increased coronary vessel wall thickness is significantly associated with diastolic dysfunction in asymptomatic middle-aged individuals living with HIV. The study, “Association between coronary artery wall thickening and reduced diastolic function in asymptomatic low cardiovascular disease risk individuals living with HIV,” was published today. Radiology: Cardiothoracic imagingthe Journal of the Radiological Society of North America (RSNA), published a news summary about this study detailed below.

As effective treatments extend the life expectancy of people living with HIV, non-AIDS-related health concerns are becoming increasingly common. Recent studies have shown that cardiovascular disease is higher in people with HIV compared with those without HIV, and rates of sudden cardiac death are estimated to be four times higher compared with the general population.

According to the World Health Organization (WHO), approximately 39 million people were living with HIV at the end of 2022. Since 2010, HIV-related deaths have decreased by 51%, but HIV remains a major global public health problem, claiming 40.4 million lives to date.

Research details

National Institutes of Health (NIH) researchers assess the relationship between early coronary atherosclerosis burden and heart function in asymptomatic people with HIV who are at low risk for cardiovascular disease. I set out to do that. For the study, researchers recruited 74 adults living with HIV (mean age 49 years) without known cardiovascular disease and 25 matched healthy controls (mean age 46 years). Controls were required to be HIV negative and healthy with no known serious medical conditions including coronary artery disease. All underwent MRI to measure coronary vessel wall thickness and echocardiography to assess left ventricular function.

“Previous studies have shown that people with HIV have cardiovascular disease, but not at very early stages,” said senior author and director of the National Diabetes Institute’s Division of Biomedical and Metabolic Imaging. said Ahmed M. Gharib, M.D., a researcher and senior clinical researcher. Digestive and Kidney Diseases (NIDDK) in Bethesda, Maryland.

HIV and control groups were matched according to age, sex, and race. Participants provided detailed reviews of their exposure to antiretroviral therapy (a combination of antiretroviral drugs used to slow the rate at which HIV makes copies of itself (replicates) in the body). A detailed medical history, physical examination, and laboratory tests were obtained from the participants. and traditional cardiovascular disease risk factors. Each participant underwent laboratory tests including fasting lipid panel, T-cell count, and HIV viral load.

Results showed that coronary vessel wall thickness was increased in the HIV group compared to controls. Increased coronary vessel wall thickness was independently associated with increased left ventricular mass index and diastolic dysfunction.

Coronary artery wall thickness was also associated with duration of exposure to didanosine, one of the drugs used in combination with other drugs to treat HIV.

“The ability to detect coronary artery disease early in HIV-infected individuals and potentially prevent adverse myocardial effects is important,” said lead author MHS, a staff scientist in NIDDK’s Division of Biomedical and Medical Sciences. said Dr. Khaled Z. Abd-Elmoniem. Department of Metabolic Imaging. He added: “This study shows the impact of HIV on the development of mild subclinical coronary artery disease and the impact of HIV on heart function.”

The researchers emphasized that early detection of asymptomatic cardiovascular disease in young people with HIV is an urgent need and may pave the way for more effective interventions and disease management.

A collaboration with Drs. Mr. Gharib and Mr. Abd-Elmoniem were Hazira Ishaq, MD, Julia Purdy, MSN, Jatin Matta, MD, PA, Ahmed Hamimi, MD, Faida Hanoush, MD, and Colleen Hadigan, MD.

More information: www.rsna.org

reference:

https://pubs.rsna.org/doi/10.1148/ryct.230102